Overweight and obesity prevalence rates among youth in the Carolinas

Overweight and obesity have become major public health concerns in the United States, reaching epidemic proportions among adults and children in recent years. According to the most recent national surveys, American adults have experienced a 50% increase in the prevalence of overweight and obesity. Moreover, an alarming 100% increase has been observed among children and adolescents since the 1970s. To assess the status of overweight and obesity prevalence among youth in the Carolinas, weight, height, waist, and hip circumferences were monitored during routine cholesterol screenings among 11- to 14-year-olds in two school districts. Of the twelve hundred students screened, 32.4% percent were overweight and 16.4% were obese, exceeding national averages of 22% and 11%, respectively. The overweight and obesity prevalence rates were even more dramatic when broken down by gender and ethnic/racial groups. For instance, 54% of black girls and 45% of black boys were overweight, and better than half of these students were obese. Overweight and obesity prevalence rates among black girls were nearly twice the rates observed for white girls. Ethnic differences in percentage of overweight and obese boys were not as great as those observed among girls. A number of factors may contribute to the unprecedented levels of overweight and obesity observed among American youth, including physical inactivity, poor nutritional habits (i.e., high-fat meals and snacks, and super-sizing), economic, and social factors. Consequently, the coordinated efforts of physicians, school nurses, teachers, parents, and students will be necessary to effectively address the growing problem of childhood obesity.     

百色市区中小学生营养状况分析

目的了解百色市区中小学生2007年营养状况,为学生营养不良、超重及肥胖的综合防治工作提供科学依据。方法按照卫生部《学校卫生情况年报表填报说明及技术规范》要求对百色市区中小学生进行身高、体重的测量,采用《1995年全国7～22岁身高标准体重值》作为评价标准。结果共检测中小学生26664名,营养不良检出率为28.93%;营养过剩率为11.59%,其中超重和肥胖检出率分别为6.38%和5.21%。营养不良检出率女生高于男生,超重和肥胖检出率男生则高于女生,城市学生高于乡镇。结论百色市区中小学生营养不良与营养过剩同时存在,应加强对中小学生的营养均衡搭配。     

青少年健康素养与肥胖相关风险因素探讨分析

目的 探讨青少年健康素养和体质量之间的联系.方法 选取2013年1月至2016年10月在该院体检中心接受健康体检的6812名青少年为研究对象,对性别、自评健康状况、健康行为等个人资料进行收集,根据体质量指数(BMI)对参与者进行分类(体质量不足、正常、体质量超标、肥胖),并让所有参与者进行青少年健康素养测试,通过调整相关协变量,对青少年健康素养和体质量间的关系进行多元Logistic回归分析.结果 6812名参与者,BMI平均值为(18.73±3.82)kg/m2,健康素养测试平均分为(25.01±6.08)分;同健康素养测试得分低于21分的青少年(17.3%肥胖)相比,得分在30分以上的青少年(12.4%肥胖)肥胖可能性低;在控制了变量健康状况自评、健康行为后,健康素养测试在30分以上的青少年体质量不足(RR=0.82,P<0.05)、体质量超标(RR=0.81,P<0. 05)或肥胖(RR=0.93,P<0. 05)的可能性较低;此外,无规律的体育活动、饮用含糖饮料的青少年更有可能体质量超标或肥胖.结论 健康素养和青少年体质量超标、肥胖之间存在密切的联系,为了避免因肥胖导致的青少年健康问题,建议加强青少年健康素养教育.     

Snowballing obesity: Australians will get run over if they just sit there

Overweight and obesity are very common in Australian adults (56%) and children (27%). Rates of overweight and obesity are snowballing and will place greater burdens on health services for the treatment and care of chronic diseases. Prevention is urgently required from health, social and economic perspectives, but the response to date has been inadequate. A long-term, sustained action plan starting with a focus on young people is needed. This should particularly address the "obesogenic" environments causing the epidemic. Although whole-of-government action is required, support from and involvement by parents, carers, community leaders, healthcare professionals, teachers, childcare workers, urban planners, recreation managers, food manufacturers, employers, advertisers, and communicators is essential. The health sector should take the lead, but success will only come from concerted and integrated action across the whole of society. There are now signs of political commitment to addressing overweight and obesity. Doctors should get behind this and help mobilise community support.     

Screening for Melanocortin 4 Receptor Mutations in Chinese Extremely Obese Individuals

Accumulating evidence indicates that overweight and obesity are the major international public health concern [1] . Obesity is a major independent risk factor for chronic diseases, such as hypertension, type 2 diabetes, cardiovascular disease, stroke, and certain cancer. Disease burden due to obesity has been dramatically increasing in many countries including     

Annual deaths attributable to obesity in the United States.

CONTEXT: Obesity is a major health problem in the United States, but the number of obesity-attributable deaths has not been rigorously estimated. OBJECTIVE: To estimate the number of deaths, annually, attributable to obesity among US adults. DESIGN: Data from 5 prospective cohort studies (the Alameda Community Health Study, the Framingham Heart Study, the Tecumseh Community Health Study, the American Cancer Society Cancer Prevention Study I, and the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study) and 1 published study (the Nurses' Health Study) in conjunction with 1991 national statistics on body mass index distributions, population size, and overall deaths. SUBJECTS: Adults, 18 years or older in 1991, classified by body mass index (kg/m2) as overweight (25-30), obese (30-35), and severely obese (>35). MAIN OUTCOME MEASURE: Relative hazard ratio (HR) of death for obese or overweight persons. RESULTS: The estimated number of annual deaths attributable to obesity varied with the cohort used to calculate the HRs, but findings were consistent overall. More than 80% of the estimated obesity-attributable deaths occurred among individuals with a body mass index of more than 30 kg/m2. When HRs were estimated for all eligible subjects from all 6 studies, the mean estimate of deaths attributable to obesity in the United States was 280184 (range, 236111-341153). Hazard ratios also were calculated from data for nonsmokers or never-smokers only. When these HRs were applied to the entire population (assuming the HR applied to all individuals), the mean estimate for obesity-attributable death was 324 940 (range, 262541-383410). CONCLUSIONS: The estimated number of annual deaths attributable to obesity among US adults is approximately 280000 based on HRs from all subjects and 325000 based on HRs from only nonsmokers and never-smokers.     

Correlates of body mass index in the 1990 Ontario Health Survey.

OBJECTIVES: To determine the average body mass index (BMI) and the prevalence of overweight and obesity among people aged 20 to 64 years, to identify sociodemographic, lifestyle and health variables that correlate with overweight and obesity, and, through a comparison of the results with those from an earlier survey, to determine whether prevalence has changed over time. DESIGN: Cross-sectional survey. SETTING: Ontario. PARTICIPANTS: The 1990 Ontario Health Survey surveyed 61,239 people representative of the Ontario population. The authors' analyses were restricted to those aged 20 to 64 years, excluding pregnant women. In the multivariate analyses they included only people with no missing values for any of the variables in the models (n = 26,306). OUTCOME MEASURES: BMI (weight in kilograms divided by height in metres squared) was used to measure healthy weight (BMI between 20 and 25), overweight (BMI greater than 25) and obesity (BMI greater than 27). RESULTS: The prevalence of obesity among men and women was 33.6% and 22.8% respectively (adjusted odds ratio [OR] 1.78, 95% confidence interval [CI] 1.63 to 1.95). There was a positive relation with age (adjusted OR 1.53 [95% CI 1.24 to 1.89] for age 25 to 29 years and 2.78 [95% CI 2.20 to 3.51] for age 50 to 54 years compared with age 20 to 24 years) and an inverse relation with education level (postsecondary education v. primary education: adjusted OR 0.65 [95% CI 0.54 to 0.79]). Analysis of birthplace showed that the prevalence of obesity was lowest among those born in Asia (compared with Canadian born: adjusted OR 0.36 [95% CI 0.27 to 0.47]). The prevalence was higher among former smokers than among those who had never smoked (adjusted OR 1.20 [95% CI 1.18 to 1.22]). People with more health problems and those who rated their health as fair or poor were more likely to be obese. The estimates of the prevalence of obesity were higher than those reported in the 1985 Health Promotion Survey for both sexes in all three age groups examined. CONCLUSIONS: These self-reported data indicate that overweight and obesity remain important health problems in Ontario, and the prevalence appears to be increasing.     

Epidemics of overweight and obesity among growing childhood in China between 1997 and 2009: Impact of Family Income,Dietary Intake,and Physical Activity Dynamics

Background:Obesity has become a major health problem among children and adolescents worldwide.This study aimed to examine the trends of overweight and obesity among childhood in China and assess their ...     

The disease burden associated with overweight and obesity.

CONTEXT: Overweight and obesity are increasing dramatically in the United States and most likely contribute substantially to the burden of chronic health conditions. OBJECTIVE: To describe the relationship between weight status and prevalence of health conditions by severity of overweight and obesity in the US population. DESIGN AND SETTING: Nationally representative cross-sectional survey using data from the Third National Health and Nutrition Examination Survey (NHANES III), which was conducted in 2 phases from 1988 to 1994. PARTICIPANTS: A total of 16884 adults, 25 years and older, classified as overweight and obese (body mass index [BMI] > or =25 kg/m2) based on National Institutes of Health recommended guidelines. MAIN OUTCOME MEASURES: Prevalence of type 2 diabetes mellitus, gallbladder disease, coronary heart disease, high blood cholesterol level, high blood pressure, or osteoarthritis. RESULTS: Sixty-three percent of men and 55% of women had a body mass index of 25 kg/m2 or greater. A graded increase in the prevalence ratio (PR) was observed with increasing severity of overweight and obesity for all of the health outcomes except for coronary heart disease in men and high blood cholesterol level in both men and women. With normal-weight individuals as the reference, for individuals with BMIs of at least 40 kg/m2 and who were younger than 55 years, PRs were highest for type 2 diabetes for men (PR, 18.1; 95% confidence interval [CI], 6.7-46.8) and women (PR, 12.9; 95% CI, 5.7-28.1) and gallbladder disease for men (PR, 21.1; 95% CI, 4.1-84.2) and women (PR, 5.2; 95% CI, 2.9-8.9). Prevalence ratios generally were greater in younger than in older adults. The prevalence of having 2 or more health conditions increased with weight status category across all racial and ethnic subgroups. CONCLUSIONS: Based on these results, more than half of all US adults are considered overweight or obese. The prevalence of obesity-related comorbidities emphasizes the need for concerted efforts to prevent and treat obesity rather than just its associated comorbidities.     

Application of the WHO Growth Reference （2007） to Assess the Nutritional Status of Children in China

Objective To assess the nutrition status of children and adolescents in China using the WHO growth reference （2007） in comparison with that defined by the International Obesity Task Force （IOTF） and the Working Group on Obesity in China （WGOC）. Methods Overweight and obesity were defined by age-, sex-, specific BMI reference developed by WHO （2007）, IOTF （2000）, and WGOC （2004）, respectively. Stunting and thinness were defined as height and BMI less than two standard deviations （SD） of the WHO growth reference （2007）, respectively. Data of children and adolescents aged 5 to 19 years （n=54 857, 28 273 boys, 26 584 girls） from the 2002 China National Nutrition and Health Survey （CNNHS） were used in the study. Results The prevalence of overweight, obesity, stunting and thinness among Chinese children and adolescents aged 5-19 years was 5.0%, 1.2%, 13.8%, and 7.4%, respectively when the WHO growth reference （2007） was used, whereas the estimated absolute total number affected by these 4 conditions were 14.6, 3.7, 40.6, and 21.8 million, respectively. The prevalence of overweight and obesity was 18.1% in large cities, while the stunting prevalence was 25.1% in rural 4. Obesity prevalence assessed by the WHO growth reference was higher than that as assessed by the IOTF reference, and obesity prevalence assessed by the WGOC reference was lower than that as assessed by the IOTF reference. Conclusion The nutritional status of children and adolescents is not equal in different areas of China. Stunting is still the main health problem of the poor, while overweight and obesity are the main health problems in large cities.     

合肥市城区学龄前儿童超重和肥胖的流行病学调查及影响因素分析

目的 了解合肥市学龄前儿童超重和肥胖的发生现状并探讨其影响因素。方法 依据地理分布、办学性质、经济情况,采用分层抽样的方法抽取合肥市11所托幼机构的儿童共2 768名,通过安徽医科大学公共卫生学院自编的《学龄前儿童健康发育调查》问卷,调查学龄前儿童超重和肥胖的发生率;采用单因素分析儿童超重和肥胖的可能影响因素,通过logistic回归分析引起儿童超重和肥胖的风险因素。结果 在2 755份有效问卷中,儿童超重发生率为9.22%,肥胖为4.94%,超重和肥胖发生率为14.20%;logistic回归分析显示,男童、剖宫产、父母体型偏胖和饮食口味偏油腻、偏荤菜是儿童超重和肥胖的危险因素,家庭经济状况较差、饮食行为中有时或需要喂养、不能愉快进餐、一般挑食、吃饭速度较慢是儿童超重和肥胖的保护因素。结论 合肥市学龄前儿童超重、肥胖发生率较高,男童、剖宫产、父母体型偏胖及部分不良的饮食行为是引起儿童超重和肥胖的原因。     

Childhood obesity: epidemiology, comorbid conditions, psychological ramifications, and clinical recommendations

The prevalence of childhood obesity in the United States has increased dramatically in recent years, doubling in the last 20 years, and is expected to result in a major public health crisis. This epidemic has left no race, socioeconomic status, or age unaffected. Children in Oklahoma are no exception; according to the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, 25% of Oklahoma's adolescents are at risk for overweight or are overweight. In order to address this problem, efforts are underway nationally to institute preventive measures for childhood obesity and its comorbid conditions.     

成都市2010、2014年社区成年居民肥胖和超重的比较与影响因素研究

目的：探讨成都市社区成年居民肥胖和超重情况的差异及影响肥胖和超重的主要因素。方法分别于2010、2014年在3个社区进行两次社区卫生服务的横断面调查。两次调查均采用多阶段随机抽样方法,在成都市某城区的3个社区进行入户问卷调查。结果2010年与2014年相比,社区成年居民超重率从27.9%上升至31.2%,其增加幅度为11.8%;肥胖率从6.9%上升至7.7%,其增加幅度为11.6%。年龄标化后,超重率由28.9%上升到30.4%,肥胖率由7.2%上升到7.5%。logistic 回归结果显示：男性超重、肥胖患病率和增长幅度均高于女性;45~<55岁超重率最高,而18~<25岁肥胖率最高且该年龄段居民超重和肥胖率增长最快;非再婚人群、低文化程度、锻炼、饮食口味重及静坐时间长的人群超重和肥胖率较高。结论成都市社区成年居民超重和肥胖率呈现逐年增加的趋势,应采取综合措施,运用健康促进理论与技术,以社区为平台,加强重点人群防治,促进不健康生活方式的改变,强化健康教育,增强自我保健意识。     

Years of life lost due to obesity

CONTEXT: Public health officials and organizations have disseminated health messages regarding the dangers of obesity, but these have not produced the desired effect. OBJECTIVE: To estimate the expected number of years of life lost (YLL) due to overweight and obesity across the life span of an adult. DESIGN, SETTING, AND SUBJECTS: Data from the (1) US Life Tables (1999); (2) Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994); and (3) First National Health and Nutrition Epidemiologic Follow-up Study (NHANES I and II; 1971-1992) and NHANES II Mortality Study (1976-1992) were used to derive YLL estimates for adults aged 18 to 85 years. Body mass index (BMI) integer-defined categories were used (ie, <17; 17 to <18; 18 to <19; 20 to <21; 21 to 45; or > or =45). A BMI of 24 was used as the reference category. MAIN OUTCOME MEASURE: The difference between the number of years of life expected if an individual were obese vs not obese, which was designated YLL. RESULTS: Marked race and sex differences were observed in estimated YLL. Among whites, a J- or U-shaped association was found between overweight or obesity and YLL. The optimal BMI (associated with the least YLL or greatest longevity) is approximately 23 to 25 for whites and 23 to 30 for blacks. For any given degree of overweight, younger adults generally had greater YLL than did older adults. The maximum YLL for white men aged 20 to 30 years with a severe level of obesity (BMI >45) is 13 and is 8 for white women. For men, this could represent a 22% reduction in expected remaining life span. Among black men and black women older than 60 years, overweight and moderate obesity were generally not associated with an increased YLL and only severe obesity resulted in YLL. However, blacks at younger ages with severe levels of obesity had a maximum YLL of 20 for men and 5 for women. CONCLUSION: Obesity appears to lessen life expectancy markedly, especially among younger adults.     

Current concepts in the management of obesity. An evidence based review

The increasing prevalence of overweight and obesity is an important public health problem contributing to significant excess in morbidity and mortality. A cross-sectional national epidemiological household survey showed that the prevalence of obesity in female Saudi subjects was among the highest reported. Obesity is a complex multifactorial chronic disease that develops from an interaction of genotype and the environment. Our understanding of how and why obesity develops is incomplete, but involves the integration of social behavioral, cultural physiological, metabolic and genetic factors. While there is agreement about health risks of over weight and obesity, there is less agreement about their management. Primary health care services should play the dominant role for obesity management. Family physicians need to assess the patient's readiness to enter weight loss therapy and take appropriate steps for motivation. Weight loss and weight maintenance therapy should employ the combination of low caloric diet, increased physical activity, and behavioral therapy. Weight loss drugs may be used as part of comprehensive weight loss program. Weight loss surgery is an option for carefully selected patients with severe obesity Body Mass Index greater than 40. After successful weight loss, a program consisting of dietary therapy, physical activity, and behavioural therapy, which should be continued indefinitely, enhances the likelihood of weight loss maintenance.     

3387名卫生学校学生超重、肥胖率和对肥胖危害认知情况的调查

目的 调查廊坊市卫生学校学生超重、肥胖及超重、肥胖学生对肥胖危害认知情况,为干预超重、肥胖提供依据.方法 测量身高、体重,计算学生超重率、肥胖率;自制问卷调查超重、肥胖学生对肥胖危害的认知情况.结果 城市学生超重率为15.12%,肥胖率为5.81%;农村学生超重率为13.57%,肥胖率为4.01%,差异无统计学意义（P ＞ 0.05）.男生超重率为16.87%,肥胖率为6.26%,女生超重率为12.86%,肥胖率为3.62%;男生对于自身超重或肥胖的认知率为51.76%,明显低于女生（91.76%）,差异均有高度统计学意义（P 〈 0.01）.结论 廊坊市卫生学校学生超重、肥胖的发生率较高,城乡差异不明显,男生超重率、肥胖率高于女生,学生对于超重、肥胖的危害认识不足,采取减重措施比例偏低.     

重庆市贫困地区人群营养健康状况评价

目的了解重庆市贫困地区人群的营养健康状况。方法采用与人口成比例抽样（PPS）,对重庆某贫困地区家庭进行抽样问卷调查和医学检查及实验室检查。结果重庆市贫困地区成年居民营养不良率、超重率和肥胖率分别为5．37％、22．07％和6．59％,儿童青少年营养不良率、超重率和肥胖率较高,分别为11．06％、8．94％和7．66％;营养相关疾病患病率较高,贫血患病率为6．90％;高血压患病率20．67％;糖尿病和空腹血糖受损患病率分别为8．92％与4．11％,均高于2002年全国居民患病率。结论重庆市贫困地区的营养健康状况不容忽视,儿童青少年超重和肥胖问题、老年人健康问题和营养相关慢性疾病将是今后面临的重要公共卫生问题。     

2004年西安市11～17岁青少年超重和肥胖现状及其相关因素

目的 了解西安市11～17岁青少年超重和肥胖的现状及其相关因素.方法 通过多阶段整群抽样方法抽取西安市6城区30所中学1 804名学生（11～17岁）,测量其身高、体重并计算体质指数（BMI）,采用2000美国疾病预防控制中心（CDC）低体重标准及中国肥胖工作组（WGOC）推荐的超重和肥胖判定标准计算低体重率、超重和肥胖率.出生体重、家庭住址、经济状况、家长学历、职业和身高、体重等信息通过家长填写问卷采集.结果 西安市青少年总超重肥胖率为17.4%（超重率11.2%、肥胖率6.2%）,其中男性总超重肥胖率为20.2%,女性为14.4%.低体重率为2.7%.多元logistic回归显示：性别、年龄、家庭居住地、家庭经济状况及父母体重与青少年超重和肥胖显著相关（P＜0.05）.经性别、年龄调整后,城区青少年超重和肥胖的风险是郊区的2.7倍（95%可信区间1.8～4.0）;家庭富裕青少年的超重和肥胖风险是不富裕家庭的1.6倍（95%可信区间1.04～2.5）;父母超重或肥胖的青少年超重肥胖发病风险是父母体重正常的1.8倍（95%可信区间1.3～2.5）.结论 超重和肥胖已经成为影响西安市青少年健康的一个主要公共卫生问题,多发于城区、经济富裕或父母肥胖的家庭,以男性居多.     

超重和肥胖对血压影响的调查及健康教育对策

目的 :分析体重指数 (BMI)对高血压患病率的影响 ,对超重和肥胖人群实施行为指导。方法 :对本社区 30岁～ 5 9岁居民 86 6人进行 BMI、血压测量及问卷调查。结果 :BMI正常组的高血压患病率最低 ,男约 17.2 9% ,女约 13.14 %。 BMI超重组高血压患病率男性约 33.0 4 % ,女性约 2 7.94 %。 BMI肥胖组高血压患病率男约 6 0 .71% ,女约 4 4 .0 0 %。BMI超重组 ,肥胖组与正常组之间的差异有高度显著性意义。结论 :随着体重指数的增加 ,高血压的发病率升高 ,二者呈显著正相关 ,加强对超重 ,肥胖人群实施健康教育及行为干预 ,保持 BMI在正常范围是预防高血压病发生的有效措施     

Report on Childhood Obesity in China （1） Body Mass Index Reference for Screening Overweight and Obesity in Chinese School-age Children

Purpose To establish and propose a national body mass index （BMI） reference for screening overweight and obesity in Chinese school-age children and adolescents. Methods 2000 CNSSCH （Chinese National Survey on Students Constitution and Health） data, including 216 620 primary and secondary school students aged 7 to 18 years old, were used as a reference population. Compared with those of the NCHS intematioanl reference, three temporary sets of cut-off BMI were proposed by testing different combinations of P85, P90, and P95. When physiological and biochemical measures between and among “obesity” “overweight”, and “normal weight” groups were taken into consideration, set Ⅱ was selected to be the most appropriate one. The sex-age-specific curves were then plotted and smoothed by using B-spline method. Results Based on the samples from costal developed metropolis, the BMI curves successfully overcame the shortcomings of lower and level-off tendency of the Chinese total population. Temporary set H, composed by cut-offs of P85 for overweight and P95 for obesity, was finally selected by its sensitivity and peculiarity. BMI 24 and 28 were used as cut-offs for overweight and obesity for both males and females aged 18 years old. These cut-offs, consistent with Chinese Adult＇s Reference, was proposed as the Body mass index reference for screening overweight and obesity in Chinese school-age children and adolescents. Conehlsion The new reference clearly showed its superiorty in both prospectivity and actuality. The proposed reference minimized the gaps of the BMI curve between Chinese adolescents and the international reference. Most importantly was that it was consistent with the Eastern Asia ethnic characteristics of body fatness growth. It was therefore proposed by the Working Group on Obesity in China （WGOC） to use it as an nationwide reference for screening overweight and obesity of school-age children and adolescents in China.